Jordan Nissinoff, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00692800 Issued in NJ

Practice address

112 Eisenhower Pkwy Ste 44
Livingston, NJ 07039-4900

Phone

(973) 535-3344

NPI assigned

Oct 16, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

EyewellnissGroup PAC ID 6406222488, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eyewellniss

  • Health Service Clinic/Center
  • Livingston, NJ
  • NPI 1578298535
  Medicare reassignment Care Compare group NPD Authorized official
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)
• Main Street Clinic, LLC

  • Pediatrics Physician
  • Pell City, AL
  • NPI 1740895291
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1497397947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 12TH ST APT PH07",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070306785",
            "telephone_number": "321-537-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 EISENHOWER PKWY STE 44",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394900",
            "telephone_number": "973-535-3344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 The Promenade Spc C5A",
            "address_purpose": "LOCATION",
            "city": "Edgewater",
            "state": "NJ",
            "postal_code": "070202127",
            "country_code": "US",
            "telephone_number": "201-945-8931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Garden State Plz",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076522417",
            "country_code": "US",
            "telephone_number": "201-712-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISSINOFF",
        "first_name": "JORDAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-16",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00692800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicu Associates at Saint Barnabas
• Bryan Niederman, PHD
• Beimnet Girma Nigussie, MD
• Rohit Nijhawan
• Gurshamshir Kaur Nijjar-Balyan, LPC
• NJ Ecc
• NJ Virtual Health Solutions
• Gladiette Nkiru, APN
• Nna-Saint Barnabas-Livingston, L.L.C.
• Nna-Saint Barnabas-Livingston, L.L.C.

• Optometrist in Livingston, NJ
• Providers in Livingston, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.